Of all the conditions that affect the upper limb, carpal tunnel syndrome is a common condition that is increasing in occurrence due to our lifestyle changes. In this condition, the median nerve – which supplies the inner palm and fingers (one half of ring and the whole little finger) – is affected. The condition occurs when the nerve is compressed as it traverses the carpal tunnel – a narrow space between the wrist bones and ligaments – through which arteries and tendons also pass.
Anything that reduces the tunnel space and causes the general irritation of the nerve can lead to the condition. These causes include pregnancy, diabetes, obesity, hypothyroidism, rheumatoid arthritis and fractures of the bones in the vicinity. These days, due to the overuse of computers and laptops – both at work and at home – repetitive stress disorder is also a cause. Maintaining the wrist in an awkward position – with the hand and fingers in the lower positing leading to a bend in the wrist – is known to increase the likelihood of developing the syndrome over a period of time.
The symptoms and signs include pain, numbness, tingling sensations, loss of sensation in the area covered by the nerve, loss of muscle mass, and weakness of the hand. In a working professional, this could result in frequent sickness absenteeism, which of course has other implications such as job loss and financial worries. Therefore, it is important that the condition is prevented before the need for a surgical release of the compression arises. Here, physiotherapy – both professionally-guided and self-learnt – plays a big role.
Physiotherapists do not recommend any active intervention in the acute period of the condition. In this situation, pain relief through rest and reducing the inflammation are considered. Some of the recommended measures are as follows:
- The underlying cause – such as diabetes, obesity and smoking – has to be treated.
- Full rest should be given to the fingers, hand and wrist; lifting heavy objects using the affected hand should be avoided.
- Cold compresses and over-the-counter pain killers may be effective in achieving pain relief.
- The wrist would have to be maintained in the neutral position – that is, it should not be at an angle to the rest of the hand and the fingers.
- If necessary, a wrist splint would have to be worn to maintain the wrist in the neutral position.
- Local muscle strength building and gliding and stretching exercises may be undertaken after obtaining proper professional guidance.